N.H.S. or Insurance?.

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Member for

14 years 5 months

Posts: 3,447

With my cards on the table - I work for a small tech company that sells its services exclusively to the uk public sector - I can honestly say I have never heard of a contract for 'outsourcing' of work of any kind ever saving the taxpayer money. It is as simple as that. Every instance I have come across, in fifteen years, of a tech service being taken from delivery by an in-house team to a paid-for delivery by the likes of Capita, G4S etc, has ended up costing more. In too many cases multiples more.

Member for

14 years

Posts: 4,996

Touch wood, I've not had the need of anything major from the NHS. I do have the need for hearing aids,
and before I went NHS bought some privately. They were about £1000 + regular payments for batteries.
Now I use NHS aids and get batteries for free. I do pay for dental care, which covers a proportion of any bills,
although to be honest I could probably go NHS.

A friend in the US has diabetes. He is no longer covered by insurance, and has spent most of his savings on
insulin. As Jim says, the older you get, the more you need, and the more expensive it gets. So I think on
balance, the NHS is best.

Member for

17 years 6 months

Posts: 9,739

I can honestly say I have never heard of a contract for 'outsourcing' of work of any kind ever saving the taxpayer money...

Including pension costs? I'd have said it was a very difficult thing to judge, unless you are absolutely comparing like-for-like, and surely unless you include pension costs, meaningless?

And, fundamentally, does it matter if taxpayers money is spent in the public-sector or in the private-sector, which, by default, then effectively becomes the public-sector? Now, I'd be the first to object to more money being spent for less return, but you have to ask yourself, if the job of government is effectively balancing the books (no, it is really!) then why would any government do something that actually costs significantly more?

The waters are, of course, muddied by the dreaded public-private-partnerships (PPP) that are attractive to governments mainly because, it seems to me, that the government of the day can demonstrate huge investment in the short term and then leave subsequent governments to pick-up the huge and ongoing cost.

Member for

14 years 5 months

Posts: 3,447

'Why would any Government do something that costs considerably more'?

Because of where the money ends up. If a local authority's in-house IT do it, the money goes on their salaries. If Capita (the largest out-sourcer, as an example) do it, the money goes on their salaries, plus the salaries of their sales, marketing and contracts team, backhanders to local authority decision makers to get/keep the contracts, AND profits for the shareholders. That last is the reason why they do it. No it 'shouldn't' happen, and in an 'aware' democracy it wouldn't, but that is not where we are living.

Member for

17 years 6 months

Posts: 9,739

So it's all some big corrupt plot is it; so that public money ends-up in the hands of 'shareholders'! :rolleyes:

Member for

14 years 5 months

Posts: 3,447

Not a plot, nothing to plot against. Just a mechanism that has evolved. No conspiracy, it's just what happens when you make public services with public funding an available cash cow for private companies. The fact it is allowed to happen is simply a facet of the Government of the time representing those such a system benefits more than those it does not. That is not a plot as such.

Member for

19 years 6 months

Posts: 1,518

I think even a cursory analysis of the US system would be an indictment of it.

They spend spend twice as much per capita for no demonstrable improvement in healthcare outcomes.

The largest cause of bankruptcy in the USA is medical bills.

MOST of these bankruptcies are from people that HAVE health insurance.

Large excess payments can leave people thousands of dollars out of pocket for their healthcare, even with insurance.

If you insurance is tied to your job (as it often is in the US) then your employer has even more power over the average worker, leaving them more vulnerable to exploitation. It also means that losing your job also means you lose affordable healthcare - not a good combination.

The NHS is far from perfect, and maybe the NHS using some private provision could work, but it's something I think we should guard jealously.

Member for

18 years 2 months

Posts: 1,071

:apologetic:

Member for

17 years 5 months

Posts: 8,980

I cannot fault the service I got, it was faultless and quick, from admission to treatment and release was one week while they investigated and treated my heart condition, in that time I had an angiogram and a angioplasty treatment and various scans which involved three stents inserting, I was then released home knowing that after 6 weeks I would be recalled for another procedure to unblock and stent the other artery, because I am home alone I was admitted for the night and released the following day so they could monitor my incision. I now have follow ups booked with my doctor and the consultant that carried out the procedure...
And all on the NHS in a new clean hospital manned by dedicated skilled staff. The room was a four man with on suite and on my second visit a private room with on suite.

Member for

24 years 2 months

Posts: 16,832

Struggling to get my head round the economics of this.....'reduce the income to the NHS'?

How does the NHS derive any 'income' from the work that they do?

Confused me too, and we still don't seem to have had an answer.

Moggy

Member for

12 years 11 months

Posts: 6,535

One of the reasons for the astonishing costs involved in healthcare in the US can be found in this sorry tale of how pure capitalism is careless with peoples lives
http://www.independent.co.uk/news/world/americas/hedge-funder-buys-rights-to-drug-used-by-aids-patients-and-raises-price-from-1350-to-750-per-pill-10511690.html

Disgraceful is inadequate to describe this news item. But then, we have our own homegrown version. Life extending drugs being denied to cancer sufferers on the dubious grounds of cost/benefit but, we can still afford to divert 900 million of the overseas aid budget of 12 billion, to Syria, effectively ignoring the plight of our NHS patients.

Member for

12 years 8 months

Posts: 851

Disgraceful is inadequate to describe this news item. But then, we have our own homegrown version. Life extending drugs being denied to cancer sufferers on the dubious grounds of cost/benefit but, we can still afford to divert 900 million of the overseas aid budget of 12 billion, to Syria, effectively ignoring the plight of our NHS patients.

There is no link between NHS and Foreign aid budgets as you well know. I would have thought you would be in favour of cost/benefit analysis for NHS treatment as you seem keen to reduce the goverment deficit.

You will have to try harder

Member for

24 years 2 months

Posts: 16,832

There is little more tiresome than perpetual use of the NHS and education as an excuse for not spending money on something that the writer does not approve of.

"With the money spent on xxxxxxxx we could build three hundred hospitals and two hundred schools."

Yes, we know that, but we do have to have something other than hospitals and schools in the country. Likewise John's harking on about the foreign aid budget. It exists, we are committed to it, live with it.

Moggy

Member for

12 years 11 months

Posts: 1,542

Not a plot, nothing to plot against. Just a mechanism that has evolved. No conspiracy, it's just what happens when you make public services with public funding an available cash cow for private companies. The fact it is allowed to happen is simply a facet of the Government of the time representing those such a system benefits more than those it does not. That is not a plot as such.

Not that I disagree with your sentiment, but the private sector is just a drop in the ocean of NHS problems. Internal inefficiencies, an utterly corrupt and unsustainable procurement system and the culture of golden handshakes and 'jobs for the boys' will be costing the taxpayer untold millions, if not billions per year.

The whole thing needs to be pared back. I admit that I don't have the answers, but it cannot continue the way it is.

Member for

17 years 5 months

Posts: 8,980

Disgraceful is inadequate to describe this news item. But then, we have our own homegrown version. Life extending drugs being denied to cancer sufferers on the dubious grounds of cost/benefit but, we can still afford to divert 900 million of the overseas aid budget of 12 billion, to Syria, effectively ignoring the plight of our NHS patients.

But that said if my heart condition was terminal and the said drugs as in the expensive cancer ones do, gave me an extra months life would I want that? Difficult, but probably not.

Member for

14 years 5 months

Posts: 3,447

The corrupt and unsustainable procurement and 'jobs for the boys' are what need to go, I agree. A way to do that is to stop the flow of contracts out.. I have seen a steady migration of senior management types leave their public sector posts to do the same job for the same council as a one-man or one-woman private consultancy 'company' for double the money.

In one case a social care Director has a second private consultancy job as an advisor to her own department.

In another an outsourcing company - Capita - run (as an outsourced service) the procurement department for a large Metropolitan Council. Whenever a new IT contract is competed for, the contract (as decided on by the Capita Procurement division) is awarded to the Capita IT division.. at a vastly inflated price. I can't speak for the NHS but I suspect it is a similar picture.

Member for

13 years 9 months

Posts: 8,306

There is little more tiresome than perpetual use of the NHS and education as an excuse for not spending money on something that the writer does not approve of.

"With the money spent on xxxxxxxx we could build three hundred hospitals and two hundred schools."

Yes, we know that, but we do have to have something other than hospitals and schools in the country. Likewise John's harking on about the foreign aid budget. It exists, we are committed to it, live with it.

Moggy

I seem to remember Cameron promising that he would build 16 new Hospitals. Anyone recall just how many have been built on his watch?. So young Moggy, it begs a question, hypothetically speaking, we have two pots, both are nearly M.T. one has NHS on it, the other has Foreign Aid on the other, YOU need a life saving Operation, but YOU have to chose which is the better of the sum total of both pots, would you have the Op, or give it away to some other Country?.remembering, you can't have it both ways.
Jim
Lincoln .7

Member for

13 years

Posts: 2,841

Go to Addenbrookes Jim you will probably have your Op cancelled to May 2045!